Tacrolimus – All Dosage Forms Are Not Created Equal

Program Overview

The dynamic nature of transplantation demands greater attention be given to this population. Despite surgical and medical advances in transplantation, the long-term management of organ transplant recipients remains complicated. Even though organ transplantation is no longer an esoteric exercise and is considered by many to be the treatment of choice for end-organ failure, many transplant practitioners are not up-to-date on the most appropriate immunosuppressive treatment modalities.

The role of tacrolimus as the cornerstone of modern day immunosuppressive regimens is unquestioned. However, with the advent of more than one once-daily formulation and generic versions of the twice-daily preparation, a proper understanding of tacrolimus’s different dosage forms and their advantages and disadvantages is imperative. This educational activity is intended to update transplant practitioners on current options for tacrolimus-based immunosuppression, with a focus on pharmacokinetics, safety and efficacy. Enhanced knowledge and clinical competency related to the optimal use of tacrolimus in transplant recipients can lead to improved management and survival in this patient population.

Objectives

At the end of this program, participants should be able to:

  • Compare and contrast the pharmacokinetic (PK) profiles of the oral tacrolimus formulations;
  • Analyze the transplant-related outcomes of the two available once-daily tacrolimus formulations;
  • Assess the toxicities of tacrolimus that are related overall exposure.

Faculty

Roy Bloom, M.D.
Roy D. Bloom, MD
Medical Director, Kidney/Pancreas Transplant Program & Professor of Medicine
Hospital of the University of Pennsylvania
Professor of Medicine at the Hospital of the University of PennsylvaniaDr. Roy Bloom received his medical degree from the University of Witwatersrand in South Africa. He underwent postgraduate training in England, a medical residency at Albert Einstein Medical Center, Philadelphia and nephrology fellowship training at both Harvard Medical School and the University of Pennsylvania from where he graduated in 1994. Since 1999, he has been a Renal Division faculty member at the University of Pennsylvania, where he is Professor of Medicine. He has been the Medical Director of the Penn Kidney Transplant Program since 2002.

Dr. Bloom is an active member of several professional societies. He has served on several ASN and AST Committees related to patient care, education and practice improvement. He has served on the ASN Public Policy Board. He has been a member of AST, KDIGO and KDOQI Work Groups for management of hepatitis C virus, as well as for kidney recipient care.

Dr. Bloom chaired the AST/ASN Transplant Course at the Annual Kidney Week until 2017 and is on the Program Committee of the AST/ASN Transplant Nephrology Core Curriculum. He is currently a member of the planning committee for AST Cutting Edge in Organ Transplantation annual meeting. He has co-authored over 160 publications. He presently serves as an associate editor for the American Journal of Kidney Diseases. Besides overseeing a robust transplant clinical trials program, his research interests include viral infections in kidney transplantation, as well as clinical immunosuppression studies and post-transplant outcomes.

Continuing Education

Accreditation Statement

In support of improving patient care, this activity has been planned and implemented by TG Medical Education LLC, ScientiaCME LLC and Amedco LLC. TG Medical Education is accredited by the Accreditation Council for Pharmacy Education (ACPE) as a provider of continuing pharmacy education. ScientiaCME is accredited by the Accreditation Council for Continuing Medical Education (ACCME) as a provider of continuing medical education. Amedco is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

ACPE
Jointly

Credit Designation Statement:

  • TG Medical Education designates this home study activity for a maximum of 1.0 contact hour (0.10 CEU) of credit for pharmacists.
  • ScientiaCME designates this home study activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
  • Amedco designates this home study for a maximum of 1.0 contact hours for nurses. Learners should claim only the credit commensurate with the extent of their participation in the activity.

Activity Type

Knowledge (0454-9999-17-002-H01-P); Release date is December 31, 2017

Date of Release (Nursing):  April 16, 2018

Date of Last Revision:  March 30,2018

Date of Expiration:  April 15, 2020

 

Method of Participation

Learners will watch the program video. Upon completion, each learner will answer evaluation questions to receive their CE certificate.

 

Bibliographic Sources

1)      Ho ET, et al. Transplantation 2013;95:1120-8.

2)      Silva HT, et al. American Journal of Transplantation 2007;3:595-608.

3)      Kramer BK, et al. American Journal of Transplantation 2010;12:2632-43.

4)      Barraclough KA, et al. Drugs 2011;12:1561-77.

5)      Rostaing L, et al. AJKD 2016;67(4):648-59.

6)      Bunnapradist S, et al.  Transpl Int 2016;29(5):603-11.

7)      Langone A, et al.  Clinical Transplantation 2015;29(9):796-805.

8)      Lee RA, et al.  Current trends in immunosuppressive therapies for renal transplant recipients. Am J Health Syst Pharm. 2012 Nov 15;69:1961-75.

 

Disclosure of Conflict of Interest

The following table of disclosure information is provided to learners and contains the relevant financial relationships that each individual in a position to control the content disclosed to Amedco.  All of these relationships were treated as a conflict of interest, and have been resolved.  (C7 SCS 6.1-­‐6.2, 6.5)

All individuals in a position to control the content of CE are listed below.

Dr. Roy Bloom has disclosed the following relevant affiliations or financial relationships with a commercial interest: Grants/research support: Alexion, CareDx, Veloxis; Consultant: Abbvie, Merck, Veloxis.

Steven Gabardi, nothing to disclose

Justin Kaiser, nothing to disclose

 

Acknowledgement of Commercial Support

This activity is supported by an educational grant from Veloxis Pharmaceuticals.


The program can be viewed at the bottom of this page.  The video can be enlarged and viewed in full-screen mode.  Once you complete watching the programd, log into your account, return to this page and click on the disclipine appropriate “Claiming CME” link below to obtain your CE.

NOTE: for pharmacists, you must include your correct NABP eID so that the credits can be transferred to the NABP within 60 days of the completion of the post-test.

Claiming CME:

  • Physicians – Claim Physician CME
  • Pharmacists – Instructions to claim Pharmacist CME

    1. Register for an account
    2. Log into your account and return to the “Online Programs” from the top menu
    3. Click on the “Complete Evaluation to claim CME” link and follow on screen instructions

  • Nurses – Claim Nurse CME

Tacrolimus – All Dosage Forms Are Not Created Equal Video


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